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Clinical, radiological and histopathological characteristics of surgically removed orbital hematic cysts: A case series
ConclusionHematic cyst is a challenging clinical diagnosis that can be aided by radiological examination and histopathological confirmation. Trauma does not seem to play a major role while presence of a pre-existing vascular lesion with spontaneous hemorrhage may be an etiologic factor. Associated cholesterol granuloma is an interesting controversial finding. Surgical intervention is curative with possible persisting motility disturbance and/or the eye deviation and worse prognosis in post-traumatic cases.
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Histiocytic lesions of the orbit: A study of 9 cases
ConclusionsEosinophilic granuloma was the most frequently encountered orbital histiocytic lesion in our series. Eosiophilic granuloma usually responded well to subtotal tumor excision, bone curettage, and intraorbital corticosteroid injections. Systemic chemotherapy was used in cases with full thickness bone destruction and adjacent dural enhancement in an effort to prevent the development of central nervous system disease.
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Inflammatory myofibroblastic tumor of the orbit: A clinico-pathological study of 25 cases
ConclusionIMT is a distinct entity which may occur in the orbit primarily. It should be considered in differential diagnosis in all orbital masses, particularly with onset of acute or subcronic inflammation. Surgical biopsy associated to a partial debulcking of the tumor, avoiding to damage adjacent vital structure may contribute to improve the outcome. Steroid therapy, seems to be the suitable as first line medical therapy, although, as reported in literature, not all cases respond to this treatment regimen. Radiotherapy, may be considered as an alternative therapy. Recurrences occurred in 24% of patients and may be treat...
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Cytogenetic results of choroidal nevus growth into melanoma in 55 consecutive cases
ConclusionsChoroidal nevus with rapid transformation into melanoma within 1 year is significantly more likely to demonstrate high-risk cytogenetic profile, at risk for metastatic disease, compared to those with slow transformation.
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Pleomorphic adenoma of the lacrimal gland: A review with updates on malignant transformation and molecular genetics
Publication date: January–March 2018Source: Saudi Journal of Ophthalmology, Volume 32, Issue 1Author(s): William Harrison, Patricia Pittman, Thomas CummingsAbstractPleomorphic adenoma (benign mixed tumor) is the most common epithelial neoplasm of the lacrimal gland. It is usually a slow growing, well-circumscribed, mass that is identical to its salivary gland counterpart. Patients generally have an excellent prognosis for vision and long-term survival after complete surgical excision. There is a tendency to reoccur, especially if there is an incomplete excision, and rarely, malignant transformation to carcinoma ex pleomo...
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

An update on mesenchymal tumours of the orbit with an emphasis on the value of molecular/cytogenetic testing
Publication date: January–March 2018Source: Saudi Journal of Ophthalmology, Volume 32, Issue 1Author(s): F. Roberts, E.M. MacDuffAbstractMesenchymal tumours of the orbit are uncommon. Beyond childhood primary sarcomas are extremely rare and the literature is limited to case reports and short case series. However there is a diverse assortment of benign and malignant soft tissue tumours that may involve the orbit. Techniques to identify tumour specific cytogenetic or molecular genetic abnormalities often resulting in over- expressed proteins are becoming an increasingly important ancillary technique for these tumours. This...
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Changing patterns in orbital pathology
Publication date: January–March 2018Source: Saudi Journal of Ophthalmology, Volume 32, Issue 1Author(s): J.G. Heathcote
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Editorial Board
Publication date: January–March 2018Source: Saudi Journal of Ophthalmology, Volume 32, Issue 1Author(s):
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Optic nerve choristoma
Publication date: January–March 2018Source: Saudi Journal of Ophthalmology, Volume 32, Issue 1Author(s): William Harrison, Patricia Pittman, Thomas Cummings
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Blastomyces species and orbital apex syndrome: Unsuspected co-infection
We report an initially immunocompetent patient with orbital apex syndrome (OAS) whose presentation suggested giant cell arteritis. Subsequently, metastatic carcinoma was entertained as a cause of OAS until bronchoscopy yielded Blastomyces species. The patient rapidly succumbed with multiorgan failure despite Amphotericin B administration. At post-mortem, Blastomyces co-infection with fungal hyphae in keeping with Aspergillus species was found in cavernous sinus and in infarcted optic nerve. To the best of our knowledge, co-infection with these two organisms in this clinical setting has not been reported.
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Bilateral orbital isolated (solitary) neurofibroma in the absence of neurofibromatosis – A case report
We report a 23-year-old female with no systemic features or family history of neurofibromatosis who presented with right upper eyelid swelling. Radiological studies revealed bilateral identical masses in the superior orbits. The patient underwent surgical excision of the lesion on the right side and it was proved to be neurofibroma. She did not have a recurrence with a follow up period of 2 years but developed sensory deficit. This is the fifth reported case of bilateral isolated neurofibroma.
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Orbital tumor associated with a microphthalmic eye and colobomatous cleft: Pilocytic astrocytoma (glioma) or massive retinal gliosis
Publication date: January–March 2018Source: Saudi Journal of Ophthalmology, Volume 32, Issue 1Author(s): Rita Van Ginderdeuren, Rafael Sciot, Ilse MombaertsAbstractA 11-year-old boy with congenital microphthalmos of the right eye presented with gradual protrusion of his ocular prosthesis. MRI showed an orbital mass adjacent to the microphthalmic eye. After removal of the eye and the orbital soft tissue mass a gliotic mass, resembling a pilocytic astrocytoma WHO grade 1 (glioma) was diagnosed. Through a colobomatous cleft in the eye the tumour spread in the orbit. There were no clinical signs of neurofibromatosis 1. This ...
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Orbital immature teratoma: A rare entity with diagnostic challenges
Publication date: January–March 2018Source: Saudi Journal of Ophthalmology, Volume 32, Issue 1Author(s): Hind M. Alkatan, Omar S. AlObaidan, Hala Kfoury, Yasser H. Al-FakyAbstractChildhood orbital teratomas are congenital lesions that presents most often at birth with progressive, severe unilateral proptosis. Due to the rarity of such tumors, the diagnosis is often missed with delay in the patient's management. We are presenting a unique case of an immature right orbital teratoma with extensive growth in a full-term newly born baby boy. In this case report, we provide description of the clinical findings, initial misdiag...
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Primary mesenchymal chondrosarcoma of the orbit: Histopathological report of 3 pediatric cases
We describe 3 additional pediatric cases with primary orbital MCS and they were all males. Our cases presented with proptosis and calcific orbital masses on imaging studies. Histopathological examination of the excised masses shared the typical presence of undifferentiated mesenchymal cells and immature areas of cartilage. The diagnosis of MCS was further confirmed by immunohistochemical staining. Brief review of the literature in relation to this diagnosis in the orbit is also presented.
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Isolated superior oblique muscle extranodal marginal zone B cell lymphoma: case report
We describe a rare case of isolated extraocular muscle ocular adnexal lymphoma of a middle-aged female who presented with redness in the left eye associated with progressive proptosis over one year. Magnetic resonance imaging of the orbit indicated isolated enlargement of the left superior oblique (SO) muscle with an apparent diffusion coefficient (ADC) of (0.77 ± 0.11 × 10−3 mm2/s). Histopathology with immunohistochemical staining of the incisional biopsy from the SO muscle belly confirmed the diagnosis of extranodal marginal zone B cell lymphoma.
Source: Saudi Journal of Ophthalmology - July 10, 2018 Category: Opthalmology Source Type: research

Investigation of factors associated with the success of adult strabismus surgery from the patient’s perspective
ConclusionsStrabismic patients with a lower socioeconomic status are more likely to achieve HRQOL success following surgery. We also show that nondiplopic patients have more psychosocial concerns than those with diplopia and that this disparity persists even after strabismus surgery.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Strabismus surgery outcomes without removal of scleral buckle in patients with previous retinal detachment repair
ConclusionsIn our study cohort, strabismus surgery without removal of the scleral buckle resulted in motor success and alleviated diplopia in the majority of patients with prior RD repair.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

A preliminary study of astigmatism and early childhood development
ConclusionsThe results suggest that uncorrected astigmatism in toddlers may be associated with poorer performance on cognitive and language tasks. Further studies assessing the effects of uncorrected refractive error on developmental task performance and of spectacle correction of refractive error in toddlers on developmental outcomes are needed to support the development of evidence-based spectacle prescribing guidelines.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Inadvertent self-induced macular laser injury in an 8-year-old girl
Publication date: Available online 19 June 2018Source: Journal of American Association for Pediatric Ophthalmology and StrabismusAuthor(s): Nitish Mehta, Edmund Tsui, Milan Ranka, Vaidehi Dedania, Gregory D. Lee, Yasha ModiAn 8-year-old girl with a history of type 1 diabetes was referred for an evaluation of pigment changes in the right macula. Curvilinear hypopigmented streaks were noted in the fovea, with corresponding disruption of the photoreceptor layer on spectral domain optical coherence tomography. On further questioning, a history of laser pointer play 2 years prior was elicited, with acknowledgement of direct las...
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Nonsurgical correction of epiblepharon using hyaluronic acid gel
ConclusionsIn our small case series, transcutaneous hyaluronic acid gel injection into the lower eyelid effectively corrected symptomatic epiblepharon; the effect was long lasting.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

A paired comparison study on refractive changes after strabismus surgery
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s): Babita Karothiya, Rolli Khurana, Soveeta Rath, Suma Ganesh
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Congenital muscular dystrophy-dystroglycanopathy, type A, featuring bilateral retinal dysplasia and vertical angle kappa
We report the case of a 9-month-old boy with developmental delay whose family sought evaluation for esotropia. Subsequent examination, imaging, and testing revealed significant motor and cognitive delay, marked weakness with appendicular spasticity, and a diffuse brain malformation. In addition, the patient had poor visual acuity, nystagmus, optic nerve hypoplasia, bilateral retinal dysplasia and retinal dragging with a large vertical angle kappa, and an avascular peripheral retina. Genetic testing revealed two known heterozygous mutations in the POMGnT1 gene confirming MDDGA3. He was treated with botulinum toxin injection...
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Prevention of Leber congenital amaurosis through preimplantation genetic diagnosis
We report the first published case of a child born without Leber congenital amaurosis through preimplantation genetic testing to a couple who had a son with a homozygous mutation in the GUCY2D gene.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Use of polymerase chain reaction (PCR) in the diagnosis of congenital toxoplasmosis
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s): Cam Loveridge-Easther, Anne-Marie Yardley, Brenda BreidensteinCongenital toxoplasmosis (CT) is a parasitic disease that causes serious fetal and neonatal harm or death. In countries that do not have antenatal screening programs, the initiation of CT treatment relies on a postnatal diagnosis. Until recently, diagnosis was based on clinical signs and immunoglobulin seropositivity, which is fraught with difficulty. In these cases, diagnosis was often delayed or treatment, which carries ri...
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Pediatric ocular trauma caused by recreational drones: two case reports
We report 2 cases of injuries to the eye and orbital structures caused by drones.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Eye salvage in diffuse anterior retinoblastoma using systemic chemotherapy with periocular and intravitreal topotecan
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s): Raksha Rao, Santosh G. Honavar, Kaustubh Mulay, Vijay Anand P. ReddyDiffuse anterior retinoblastoma is an infrequent presentation in which the tumor is confined to the anterior segment, and there is no retinal mass. An 18-month-old Asian Indian boy presented with white spots in the left eye. There were extensive anterior segment seeds without a retinal tumor. Fine-needle aspiration biopsy confirmed the diagnosis of retinoblastoma, and the patient received intravenous chemotherapy with ...
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Alacrima, a rare cause of pediatric dry eye
We report the case of a 12-year-old boy who presented with a history of 4-5 years of severe bilateral photophobia, with exacerbation and increased ocular pain for 3-4 days. There were no systemic signs, and serology tests were negative; however, parents noted crying without tears since birth. Computerized tomography of the orbits revealed bilateral hypoplasia of lacrimal glands. A clinico-radiological correlation suggested a diagnosis of alacrima, a rare entity that should be considered in the differential diagnosis of severe pediatric dry eye, which is itself a commonly overlooked condition. In addition to artificial te...
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Clinical features of LONP1-related infantile cataract
This report highlights our clinical experience with children referred for the management of infantile cataract who were found to harbor biallelic LONP1 gene mutations. Ptosis, external ear abnormalities, and joint abnormalities were accompanying findings and thus should raise suspicion for mutations in the gene when one or more are present in children with infantile cataract.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Ocular injury during fetal endoscopy surgery
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s): Mariana Flores-Pimentel, Alejandra G. de Alba CampomanesA premature infant born at 31 weeks’ gestational age was evaluated for periocular laceration and retrobulbar hematoma secondary to injury during a percutaneous fetal procedure. He later developed optic nerve atrophy.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

A novel surgical technique employing donor sclera in strabismus surgery
We describe a novel surgical technique employing donor sclera as a spacer to solve the problem encountered in complicated cases of restrictive strabismus surgery when no more muscle or tendon is available for surgical extension of the eye muscle to correct the angle of deviation. This is often the case in patients who have previously undergone extensive surgery and in patients with mechanical restrictions, such as thyroid-associated orbitopathy (TAO).
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Visual impairment evaluation in 119 children with congenital Zika syndrome
ConclusionsInfants with CZS present with severe visual impairment. A protocol for assessment of the ocular findings, visual acuity, and visual developmental milestones tested against age-matched controls is suggested.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Prevalence of uncorrected refractive errors among school-age children in the School District of Philadelphia
ConclusionsIn this urban population 13.1% of school-age children exhibited uncorrected refractive errors. Blurred vision may create challenges for students in the classroom; school-based vision screening programs can provide an avenue to identify and correct refractive errors.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Intravenous dexmedetomidine augments the oculocardiac reflex
ConclusionsSimilar to the effect of fentanyl, intravenous fast-push dexmedetomidine augmented the bradycardia associated with extraocular muscle traction.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Oregon Elks Children's Eye Clinic vision screening results for astigmatism
ConclusionsIn 2013 the program used the 1.50 D setting for astigmatism. Changing the astigmatism setting to 2.25 D; , 85% of referrals required treatment, reducing false positives by 34%.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Low-vision aids improve the visual performance of children with bilateral chorioretinal coloboma
ConclusionsLVAs enable meaningful improvements in the visual performance of children with bilateral CRC, allowing noteworthy increases in distance and near visual acuities as well as good reading speeds at small print sizes.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Funduscopic examination and SD-OCT in detecting sickle cell retinopathy among pediatric patients
ConclusionsThe peripheral retina could be visualized on fundus examination but not easily imaged on SD-OCT, which, however, had a higher detection rate and offered earlier diagnosis. In our patient cohort SD-OCT showed that the severity of retinal change was associated with more severe sickle cell disease genotypes (SS and Sβ0).
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

An Eye on the Arts—the Arts on the Eye
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s):
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Cataract development associated with long-term glucocorticoid therapy in Duchenne muscular dystrophy patients
ConclusionsIn patients undergoing GC therapy for DMD, the rate of cataract formation was slow and well tolerated, with a higher risk among deflazacort patients. The percentage of patients requiring cataract extraction or with elevated IOP was very small. These findings suggest that a schedule of annual eye examinations is appropriate.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Long-term efficacy of endoscopic cyclophotocoagulation in the management of glaucoma following cataract surgery in children
ConclusionsIn this patient cohort, with average follow-up period of 7.2 years, ECP was useful in the treatment of pediatric GFCS.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Seeing Is Believing
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s):
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Bruch’s membrane opening on optical coherence tomography in pediatric papilledema and pseudopapilledema
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s): Masoud Aghsaei Fard
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Seeing Is Believing
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s):
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Adjustable suture strabismus surgery in infants and children: a 19-year experience
ConclusionsUse of adjustable sutures in horizontal eye muscle surgery in children ≤15 years of age provided an improved success rate and fewer reoperations compared with nonadjustable sutures.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Strabismus surgery for Medicare-aged patients: more than a decade of insights
ConclusionsGiven the functional and psychosocial impact of strabismus in the elderly, this study lends support to consideration of surgery as a viable option to successfully treat strabismus among the oldest age cohorts.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

The clinical effect of surgical timing in infantile exotropia
ConclusionsIn this patient cohort, earlier surgery did not necessarily lead to better sensory outcomes, and reoperation was associated with younger age at time of first surgery.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Information for readers
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s):
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Bruch's membrane opening on optical coherence tomography in pediatric papilledema and pseudopapilledema
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s): Javier García-Montesinos, Francisco J. Muñoz-Negrete, Elisabet De Dompablo, Gema Rebolleda
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Reply
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s): Atalie Carina Thompson, Mays A. El-Dairi
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research

Surgical success and lateral incomitance following three-muscle surgery for large-angle horizontal strabismus
Publication date: June 2018Source: Journal of American Association for Pediatric Ophthalmology and Strabismus, Volume 22, Issue 3Author(s): Soveeta Rath, Rolli Khurana, Suma Ganesh, Manasvini Sharma, Babita Karothiya
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - July 10, 2018 Category: Opthalmology Source Type: research